{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:33:12Z","timestamp":1769160792028,"version":"3.49.0"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"vor","delay-in-days":99,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Avicenna J Med"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Frailty has been associated with inferior outcomes in patients with primary pulmonary hypertension (PPH). There is a lack of national data to assess if hospital frailty risk score (HFRS) is associated with worse inpatient outcomes in PPH.<\/jats:p><jats:p>\n          Methods\u2003Our retrospective study used the Nationwide Readmission Database (NRD). First, we extracted all cases older than 18 years who were discharged with a principal diagnosis of PPH between January and November 2016 to 2019 to allow for a 30-day follow-up. Appropriate survey and domain analyses were applied to obtain national estimates using SAS 9.4.<\/jats:p><jats:p>\n          Results\u2003We identified 4,555 cases. HFRS &lt;5 was present in 56% (n\u2009=\u20092,555) of the cohort. Patients with an intermediate-to-high frailty risk score (HFRS \u22655) were older than those with a low frailty risk score (HFRS &lt;5), with a mean age of 61 versus 54 years (p\u2009&lt;\u20090.01), and had slightly fewer women (75 vs. 78%, p\u2009=\u20090.09). Patients with HFRS &gt;5 had a higher prevalence of dementia, depression, diabetes mellitus, malignancy, acute encephalopathy, coagulopathy, heart failure, and chronic (liver and renal) diseases (p\u2009&lt;\u20090.01). Also, they had higher inpatient mortality during index admission (14 vs. 2%, p\u2009&lt;\u20090.001), and all-cause 30-day readmission rates (38 vs. 33%, p\u2009=\u20090.01). Univariate analysis suggests a positive correlation between the degree of frailty and the odds of inpatient mortality (referenced to HFRS &lt;5). The HFRS 5 to 10 group has an odds ratio (OR) of 5 (95% confidence interval [CI]: 3.3\u20138), the HFRS 10 to 15 group has an OR of 14 (95% CI: 8\u201323), and the HFRS &gt;15 group has an OR of 20 (95% CI: 9\u201345). Even after adjusting for age, gender, and significant comorbidities, the single most important factor associated with higher odds of inpatient mortality was HFRS &gt;5 (OR: 5.5 [95% CI: 3.7\u20138.3], p\u2009&lt;\u20090.001) followed by acute myocardial infarction, acute encephalopathy, heart failure, chronic liver disease, and malnutrition. Length of stay had linear trend with HFRS (mean of 6 days for HFRS &lt;5 vs. 11 days for HFRS 5\u201310 vs. 19 days for HFRS &gt;10, p\u2009&lt;\u20090.001).<\/jats:p><jats:p>\n          Conclusion\u2003Adverse inpatient outcomes correlate with the severity of HFRS in PPH.<\/jats:p>","DOI":"10.1055\/s-0044-1801349","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T23:58:31Z","timestamp":1736380711000},"page":"204-209","source":"Crossref","is-referenced-by-count":2,"title":["Impact of Frailty on Inpatient Mortality and Resource Utilization for Primary Pulmonary Hypertension"],"prefix":"10.1055","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3207-6555","authenticated-orcid":false,"given":"Rayaan","family":"Rauf","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Missouri\u2013Kansas City, Kansas City, Missouri, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheryl A.","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad Alhoda Mohamad","family":"Alahmad","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,1,8]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1242\/dmm.003616","article-title":"Idiopathic pulmonary arterial hypertension","volume":"3","author":"A L Firth","year":"2010","journal-title":"Dis Model Mech"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"2481","DOI":"10.1007\/s12325-023-02501-5","article-title":"Predicting risk of 1-year hospitalization among patients with pulmonary arterial hypertension","volume":"40","author":"C Zhang","year":"2023","journal-title":"Adv Ther"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.jamda.2013.03.022","article-title":"Frailty consensus: a call to action","volume":"14","author":"J E Morley","year":"2013","journal-title":"J Am Med Dir Assoc"},{"issue":"10","key":"ref4","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1177\/1753465817726314","article-title":"Frailty is a predictive factor of readmission within 90 days of hospitalization for acute exacerbations of chronic obstructive pulmonary disease: a longitudinal study","volume":"11","author":"R Bernabeu-Mora","year":"2017","journal-title":"Ther Adv Respir Dis"},{"issue":"11","key":"ref5","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1016\/j.amjmed.2005.01.062","article-title":"Frailty, hospitalization, and progression of disability in a cohort of disabled older women","volume":"118","author":"C M Boyd","year":"2005","journal-title":"Am J Med"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1001\/jamasurg.2017.4007","article-title":"Association of patient frailty with increased morbidity after common ambulatory general surgery operations","volume":"153","author":"C D Seib","year":"2018","journal-title":"JAMA Surg"},{"issue":"06","key":"ref8","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/j.jamcollsurg.2010.01.028","article-title":"Frailty as a predictor of surgical outcomes in older patients","volume":"210","author":"M A Makary","year":"2010","journal-title":"J Am Coll Surg"},{"issue":"07","key":"ref9","doi-asserted-by":"crossref","first-page":"e0255122","DOI":"10.1371\/journal.pone.0255122","article-title":"Impact of frailty on clinical outcomes and resource use following emergency general surgery in the United States","volume":"16","author":"J Hadaya","year":"2021","journal-title":"PLoS 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Care"},{"issue":"07","key":"ref16","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1097\/MLR.0000000000000735","article-title":"Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: the AHRQ Elixhauser Comorbidity Index","volume":"55","author":"B J Moore","year":"2017","journal-title":"Med Care"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.2147\/CIA.S173239","article-title":"Frailty assessment in older adults with chronic obstructive respiratory diseases","volume":"13","author":"C Guan","year":"2018","journal-title":"Clin Interv Aging"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"e1606","DOI":"10.1097\/TXD.0000000000001606","article-title":"The relationship between rehabilitation and frailty in advanced heart or lung disease","volume":"10","author":"V Dinesh","year":"2024","journal-title":"Transplant Direct"},{"issue":"05","key":"ref19","doi-asserted-by":"crossref","first-page":"439.e9","DOI":"10.1016\/j.jamda.2015.02.005","article-title":"Effects of an oral nutritional supplementation plus physical exercise intervention on the physical function, nutritional status, and quality of life in frail institutionalized older adults: the ACTIVNES study","volume":"16","author":"P Abizanda","year":"2015","journal-title":"J Am Med Dir Assoc"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1093\/gerona\/glu110","article-title":"Strength and function response to clinical interventions of older women categorized by weakness and low lean mass using classifications from the Foundation for the National Institute of Health sarcopenia project","volume":"70","author":"M S Fragala","year":"2015","journal-title":"J Gerontol A Biol Sci Med Sci"}],"container-title":["Avicenna Journal of 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